TEMPLE UNIVERSITY TRAVEL AND EXPENSE REPORT

NAME TUid PHONE # DEPARTMENT DEPT. PHONE

STREET ADDRESS CITY STATE ZIP INDICATE CHANGE

OF ADDRESS

PURPOSE OF TRAVEL OR ENTERTAINMENT CONTACT PERSON PHONE

EMPLOYEE_________ NON-EMPLOYEE__________ DESTINATION TRAVEL MODE DEPART DATE RET. DATE

U.S. CITIZEN OR OTHER U.S. CITIZEN OTHER
PERMANENT RESIDENT VISA TYPE PERMANENT RESIDENT VISA TYPE
ALIEN ALIEN
AUTOMOBILE AUTOMOBILE AIR TAXI PARKING, LODGING MISCELLANEOUS MEALS
DATE DAY BUSINESS MILEAGE OR LIMOUSINE OR TOLLS CAR (ROOM + TAX) (EXPLAIN BELOW) B L D I TOTAL
MILEAGE EXPENSE RAIL FARE PUBLIC TRANSIT RENTAL
0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
TOTALS
BRIEF EXPLANATION OF MISCELLANOUS EXPENSES AMOUNT )81'25*$&&2817352*5$0 AMOUNT
TOTAL REIM-
$ BURSED AMOUNT $ 0.00
LIMIT ON EXPENSES $
$ 0.00
LESS ADVANCE $
$
AMOUNT DUE $
$ 0.00
APPROVAL (BUDGET UNIT HEAD) DATE APPROVAL (DEPARTMENT HEAD) DATE
SIGNATURE OF PAYEE DATE X X
PRINT NAME PRINT NAME
X
I HEREBY CERTIFY THAT THE ABOVE STATEMENT OF EXPENSES WERE INCURRED BY SEND APPROVED TRAVEL REIMBURSEMENT CENTER
ME WHILE ON DUTY FOR TEMPLE UNIVERSITY AND I HAVE NOT RECEIVED ANY REPORT TO: WACHMAN HALL, 10TH FLOOR
COMPENSATION FOR THESE EXPENSES. TU ZIP 038-26